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45 VALIANT WAY - BUILDING INSPECTION 3Lta - r 20Z-7s 34C)Lf�° `'f'�e�Coml�o3t e�l�ltl�f'�I�ssacsetA- Department of Public Safety ➢➢➢VVV Massachusetts State Building Code(780 CMR) Ss !i9• a1',1N .r,P} .V)!i iZr hp"rjd:ffYW Application for an Bui fitg-0�Gte; r Y x, k�$�t d!'�t�a-or Two-Family'Dave�fin t (This Section For Official Use Only) Building Permit Number Date Applied: 2 Building Official: T.-S S CCION 1:LOCATION(Please indicate Block N and Lot N for locations for which a street:address is not available) s �� tGt.1 G,,y n MA © 1g7G No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK. Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below Existing Building Cl Repair❑ Alteration Addition❑ 1 Demolition ❑ (Please fill out.md submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No,� Is an Independent Structural Engineerin Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Wor evvx o d -j"G(,�y� , .� v- �c d w 1J vi G wn62 a SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): - SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 0. 0 O Total Area(sq.ft.).and Total Height(ft.) -z Du S5— " SECTION 5:USE GROUP(Check as applicable) (/ \l A: Assembly A-I❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ B: Business ❑ E: Educational ❑ .� F: Facto F-1 ❑ F2❑ H: High hazard H-1❑ H-2❑ H-3 ❑ H-�4❑ H-5❑ 1: Institutional I-1 ❑ 1-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-1❑ R-2❑ R-3❑ R-4❑ S: Storage S-1❑ S-2❑ U: Utility❑ Special Use[land please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as a plicable) L\ ❑ IB ❑ IIA ❑ IIB ❑ ILIA ❑ I1I8 ❑ IV ❑ VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 C,MR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: ` Public l� Check if outside Flood Zone lilt icote municipal r\trench will not be Licensed Disposal Site❑ Private❑ or indentify Zone: or on.ite system❑ required f*or trench or specify: permit is enclosed❑ J .� Railroad right-of-way: Ilazards to Air Navigation: \IA I,Ik of i i ,In7_mj to m ll picq/ .. ..... Not Applicable(Y Is Structure within airport approac wren? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No� Yes❑ No SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code Use Group(s): 'type of Construction: Occupant Load per Floor: Dues the building contain an Sprinkler System?: Special Stipulations: TO CA N�' C�i 0 B- SECFION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Pro erty Owner ,at r6e �- 45 yal►a►�r4- I�.be�__� Name(Print) No.and Street ity/Town Zip �-/ Property Owner Contact Information: Q 'title Telephone No.(business) p none No. (cell) e-mail address I plicable,t e property caner hereby a rorizes a� ��� 33 U ��Z P�atrb Mtn a � 94S Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit a22lication. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) (If building is less than 35,000 cu.ft of enclosed space and or not under Construction Control then check here❑ai Vkiplection 10.1 10.1 Registered Professional Responsible for Construction Control Nome(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contra for c Name 021Q- �S `D9 CcC 2Cy V 2 �( Name of Person Respon u for Construction License No. and Type if Applicable Street Address City/Town 91— Statte zip Telephone No. business Telephone No. cell -mail address SECTION 11:V 01tKER5'CONHIENSA'I'[ON INSURANCE-%]HIJAVI'I M.G.L.C.152. 25C 6 A Workers'Compensation Insurance Affidavit from the NIA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a si ned Affidavit submitted with this application? Yes❑ No ❑ - - SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Estimated Costs:(Laborl Item and Materials) Total Construction Cost(from Item 6)_$ 1. Building S41 , 000 Building Permit Fee=Total Construction Cost x_(Insert here 2. Electrical $ �'1j� appropriate municipal factor)_$ 3. Plumbing d.\Icchanic l (HVAC) $ Note: Minimum fee=5 (contact municipality) 5. Mechanical Other $ 2 ll Enclose check payable to 6.Total Cost S ? (contact municipality)and write check number here SECTION 13: AT RE OF BUILDING PERMIT APPLICANT By entering my name below, I hereby attest nder fe a' s and penalties of perjury that all of the information contained in this ap ti e an, accurate to tut best m d m ider anJing. 42,`''2 � 15�1 L i DG�nI u/L. 791 b�� !J� .7 �L Pl e print 1 sign nam° Title Tclepho� No. Date Street Address City/Town State Zip Nlunicipal Inspector to fill out this section upon application approval: Name Date � 4oq M ad 9 Norman Bogosian PO Box 4523 Property Manager Salem, MA 01970 Office(978)745-2225 Fax(978)745-2251 E-Mail: Norm Bogosian@Comeast.net October 24, 2013 Paul Haggett Haggett Contractors Cell Phone: (781) 696-5439 Email: HaggettCo@Comcast.net RE: 45 Valiant Way Village at Vinnin Square Dear Mr. Haggett, Pursuant to our conversation this afternoon it is my understanding that the new unit owners of 45 Valiant Way plan on having the following changes made to the unit prior to moving in: 1. Kitchen Renovation 2. Bathroom Renovation 3. Replacement of windows 4. Replacement of doors As the property manager and on behalf of the Trustees of the Village at Vinnin Square Condominium Trust your company has permission to to do all of the above renovations and replacements to 45 Valiant Way providing... i 1.The exterior appearance of the existing windows and doors are maintained With your selected replacement units. 2. Your installation meets or exceeds the existing building codes in Salem, MA 3. Your company provides proof of insurance to the Association I 4. Your Company works between the hours of 8 am and 5 pm, Mon through Friday 5. Your company cleans up all debris at the end of each day j 6. Usage of a dumpster is permitted on the driveway of Unit #45 during this renovation project If you should have any questions please call the office at (978) 745-2225 or email at NorinBogosian@Comcast.net Very truly yours, � /�B/5or2t' Bo�98i'21t j Property Manager cc: Trustees - Village at Vinnin Square Condominium Trust I ail Rogo99n and Company LLC(Prnperty Management Co.) CITY OF Sall .r M �i' NSSACHUSETTS BUILDING DEP_xR-nffNT p< 120 WASHIINGTON STREET, San FLOOR T EL- (978) 745-9595 F.mN(978) 740-9946 KINtBERf FY DRISCOLL SOMAS ST.PIFRR& MAYOR DIRECTOR OF PUBLIC PROPERTY/BUMDLNG COXib1ISSIONER Workers` Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers A inlicant Information Please Print Legibly Naine (13usincsiOrgani7atiOMndividua1): `, Address: �' /�_ ' `,-`t_(��_✓' n� �T City/State/Zip: MAt-WAXA l MA qA Phone #: Arc y an employer?Check the appropriate box: 't'ype of project(required): 1. I am a employer with 7/ 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors ,�, o.❑ 1 am a sole proprietor or partner- listed on the attached sheet.t �• L1YRemodelittg ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers'comp.insurance. 9, ❑ Building addition (No workers' comp. insurance 5. ❑ We are Scorporation and its s have exercised their f0.❑ Electrical repairs or additions required.] officer 3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself. (No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]1 employees. LN'o workers' 13.0 Other comp. insurance required.] •Anv applicant that chucks box s I.must also fill out the section Wow showing their workers'compenottiun policy inlbrmation. t I lomeownmrs who submit this afiidnvit indicating they arc doing all work and then hire outside contractors most submit a new afridavit indicating such. Cnmmsaon thus chock this boa must astachod an addhiowl sheet showing the name of the sob.ontractors and Ihcir workers'comp.policy infomtation. l ant an employer that is providing{workers'compemsollon lnsurance for my erttplmyees. Below is the policy and Job site information. G� ��- Insurance CompanyName: SgtX�--t IJ� _ Policy #or Self-ins. Lic. #: 4 1 0 Expiration DatteCe:_nny,,,,[_L p� /� pT^� Job Site Address: 0.M(V\+ City/State/Zip:_&If ). t0--6, l- `0 Attach a copy of the workers'compensation policy hilidaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S'_.i0.00 a da inst the violator. 13e advised that a copy of this statement may be forwarded to the Office of Investigations ofthe IA Ninsuranc coverage verification. /do/tetchy cerri render th sin wr peas ics of perjury that the lnjannutlor provided above is true and carrert ID S' •nu Irr ---•� /' {)ate: cIt3 O/ficiul use only. Do not write in this area,to be completed by chy at town offichil City or Tuwn: Permitfldcense#— ....... Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.C'itylfown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Olher tit l;v�c c of rJ m D rz r��R t tJCo, 7i�2'W E:tEN vee I r1NK-ar k" S'� — CL t Utz FLAI1 I 45 V A.L l At-k T W A`f flrwo a-f ?AUL, ltl�Gto(S t'�' CITY OF S.AI..ENI, U)SSACHUSETTS • BI:iwLNr,DEPARTStENT N 130 WASHt:NGTON STREET, 3iiD FLOOR TEL (978) 745-9595 F.L.K(978) 740-9846 KI\{BERLEY DRISCOLL M.-%YOR THosw ST.Ptma DIRECTOR OF PUBLIC PROPERTY/BUILDNG CONWISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 1 t 1.5 Debris, and the provisions of NIGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. r The debris will be transported by: y I" Ili o aje S v �ev"ts (name of hauler) VW6-,-o4I K4 oz3l3 The debris will be disposed of in : ------ (name of facility)- ---� (address of facility) i siznatu o pe a plicant date